Scabietic nodules: a dermatopathologic and immunofluorescent study.

Mites and their eggs were thought to be rarely found in nodular lesions of scabies. However, serial sections from 27 scabietic scrotal papules or nodules revealed mite parts in 22% (6/27). This supports the contention that scabietic nodules may result from persisting antigens of mite parts. In contrast to previous studies, vasculitis with fibrinoid degeneration was uncommon (3/27) in our series. This discrepancy may be due to the timing of the biopsies: 2 of 3 cases with vasculitis were associated with diffuse dense infiltration, and vasculitis may be a late event in the development of scabietic nodules. The specificity of immunoreactant deposits along the epidermodermal junction (EDJ) in scabies is controversial. In our study, direct immunofluorescence (DIF) was performed on 13 scabietic nodules. Four (31%) showed immunoreactants at the EDJ and two on blood vessels. Because of the relatively low positive rate, the low intensity of fluorescence, and 3 of 4 cases with positive immunoreactants having only a single class of immunoglobulin, the deposition may only be secondary to inflammation instead of a specific type II immunologic reaction to scabies.

Malignant melanoma: a clinicopathologic study of 22 cases.

To provide updated clinicopathologic information on malignant melanoma, we studied 22 cases of malignant melanoma registered at Tri-Service General Hospital, Taiwan from 1983 to 1988. About 60% (13/22) of the patients had a tumor thickness of more than 2.5 mm and 45% (10/22) of the patients of over 4 mm. No patient had a thin melanoma (tumor thickness less than 0.76mm) when first diagnosed. Forty-four percent of the patients, which was twice as many as those (22%) in a previous study done at the same hospital, were classified as stage III. Eleven patients (50%) had acral lentiginous melanoma, the most common type of malignant melanoma in Orientals as previously reported. The cumulative survival rate was 59% and 39% at 3 years and 5 years respectively. The age primary sites, clinical stage and tumor thickness were retrospectively evaluated. Due to the small sample size, the accuracy of the statistical analysis of survival is questionable. An extensive island-wide multicenter epidemiologic study is mandatory to clarify this issue.